Full Title of Guideline: PPCI STEMI Guidelines 2019

Full Title of Guideline: PPCI STEMI Guidelines 2019

Author (include email and role): Richard Varcoe

Division & Speciality: Cardiology. Medicine.

Version: Version 2.

Ratified by: Cardiology Governace. Cardiology Consultants.

Scope (Target audience, state if Trust

wide): Adult ED clinicians. EMAS.

Review date (when this version goes out

of date): July 2024

Explicit definition of patient group to which it applies (e.g. inclusion and

exclusion criteria, diagnosis):

Adult patients with STEMI

Changes from previous version (not

applicable if this is a new guideline, enter below if extensive):

Contact numbers updated. Appendix 1 bllep system pathway updated.

Summary of evidence base this guideline has been created from:

Myocardial infarction with ST-segment elevation : acute management. Clinical guidline CG 167. 2013.

This guideline has been registered with the trust. However, clinical guidelines are guidelines only. The interpretation and application of clinical guidelines will remain the responsibility of the individual clinician. If in doubt contact a senior colleague or expert. Caution is advised when using guidelines after the review date or outside of the Trust.

Nottingham University Hospitals PPCI Guidelines July 2019 1

Written by:

Tim Graves (Specialist Cardiac Nurse)

Liz Cope (Specialist Cardiac Nurse)

Richard Varcoe (Consultant Cardiologist)

Ratified by:

Cardiology Governance (June 2019)

Review date:

July 2024

PPCI-STEMI Guidelines

2019Primary Percutaneous Coronary Intervention (PPCI) guidelines for the treatment of patients with ST elevation myocardial infarction (STEMI)


Index

PPCI referral pathway from Queens Medical Centre, p.3-4

Newark and Ilkeston hospitals

PPCI referral pathway from Kings Mill hospital p.5-6

PPCI referral pathway via East Midlands Ambulance Service p.7

Anaesthetic support for emergency PPCI cases p.8

Operational guidelines p.9-13

PPCI service in hours standard operating procedure p.14

PPCI service out of hours standard operating procedure p.15

Appendix 1 – bleep system p.16-19


Nottingham University Hospitals (Nottingham City campus) PPCI referral pathway for STEMI patients presenting to the

Queen’s Medical Centre, Newark Hospital and Ilkeston Hospital

Uncomplicated STEMI

One of the following ECG features of STEMI :

2mm or more ST elevation in 2 or more consecutive chest leads

OR 1mm or more ST elevation in 2 or more limb leads OR Posterior STEMI - ST depression in 2 or more consecutive chest leads (V1-4) and 0.5mm or more ST elevation in 1 or more posterior leads (V7-9)

Clinical presentation Cardiac sounding chest pain for <12 hours

Complicated STEMI / uncertain STEMI diagnosis

Late presentation STEMI (ie chest pain> 12 hours, now chest pain free, Q waves)

Left bundle branch block

Unclear that the patient’s history is definitely a STEMI (ie more suggestive of pericarditis or musculoskeletal etc)

Unclear that the patient’s ECG is definitely a STEMI (ie more suggestive of high take off or pericarditis)

Patients who present without chest pain - may be considered for PPCI if they present with ST elevation with associated symptoms (ie collapse with complete heart block or acute SOB with associated symptoms ie pale, clammy)

Patient is unconscious / intubated

Patient has significant co morbidities. (ie severe cognitive impairment, frailty, housebound, nursing home care, end of life pathway etc)

ED (or ward) staff to discuss patient with NCH cardiology SpR on-call (available 24/7) – 07713097021 If no reply, phone ACU – 56213 or 53117 ECG’s can be sent via fax 0115 9627688

24/7 (non-PPCI) cardiology consultant cover at QMC is available for advice

If accepted for PPCI, NCH cardiology SpR on-call to inform NCH ACU and ED (or ward) staff to arrange transfer as instructed below If not suitable for PPCI NCH cardiology SpR on-call to advise transfer to appropriate department

Refer directly to NCH ACU as instructed below – 0115 9934995


Uncomplicated STEMI Complicated STEMI accepted by NCH cardiology SpR on-call

NCH ACU co-ordinator instigates PPCI protocol and checks NOTIS for recent bloods, clinic letters, previous PCI or CABG details

Ambulance crew takes patient to TCC ambulance entrance. Cardiac Nurse to meet ambulance crew at entrance to TCC

If expected transfer delay is over 60 minutes consider thrombolysis AFTER discussion with the NCH Cardiologist

ED (or ward) staff to inform NCH ACU (0115 9934995) when the patient physically leaves referring hospital

Arrange transfer for PPCI

Telephone Nottingham City Hospital ACU (0115 9934995) with patient details and ETA.

Give Aspirin 300mgs orally and Prasugrel 60mg orally. OK to give if already on antiplatelets/anticoagulants (Heparin is not required at this point)

ED (or ward) staff to activate EMAS – dial 999 and book as

Time critical transfer – escort if appropriate

Blue light transfer directly to Trent Cardiac Centre CSSU – ground floor

NCH ACU to liaise with NCH anaesthetists if patient intubated / ventilated (see p.8)

If patient stable and after cardiology consultant review at TCC, transfer for PPCI felt to be clearly inappropriate, then transfer back to referring hospital may be considered

Minimum transfer data required - Name - DOB - K number


Nottingham University Hospitals (Nottingham City campus)

PPCI referral pathway for STEMI patients presenting to

King’s Mill Hospital

Uncomplicated STEMI

One of the following ECG features of STEMI :

2mm or more ST elevation in 2 or more consecutive chest leads

OR 1mm or more ST elevation in 2 or more limb leads OR Posterior STEMI - ST depression in 2 or more consecutive chest leads (V1-4) and 0.5mm or more ST elevation in 1 or more posterior leads (V7-9)

Clinical presentation Cardiac sounding chest pain for <12 hours

Complicated STEMI / uncertain STEMI diagnosis

Late presentation STEMI (ie chest pain> 12 hours, now chest pain free, Q waves)

Left bundle branch block

Unclear that the patient’s history is definitely a STEMI ( ie more suggestive of pericarditis or musculoskeletal etc )

Unclear that the patient’s ECG is definitely a STEMI (ie more suggestive of high take off or pericarditis etc)

Patients who present without chest pain - may be considered for PPCI if they present with ST elevation with associated symptoms (ie collapse with complete heart block or acute SOB with associated symptoms ie pale, clammy

Patient is unconscious / intubated

Patient has significant co morbidities. (ie severe cognitive impairment, frailty, housebound, nursing home care, end of life pathway etc)

KMH ED (or ward) staff to discuss patient with KMH cardiology consultant on-call (available 24/7)

If KMH cardiology consultant feels that the patient is eligible for PPCI they can activate the PPCI pathway directly as instructed below – 0115 9934995 Complex cases can be discussed with the on-call NCH cardiology consultant (0115 9691169 Ex 56155 to be put through to mobile) If no reply, phone ACU – 56213 or 53177 (consultant or SpR may be scrubbed) Fax no: 0115 9627688 addressed to ACU and staff member if sending ECG’s

If accepted for PPCI, NCH cardiology consultant to inform NCH ACU as instructed below. KMH cardiology consultant to instruct ED (or ward) staff to arrange transfer as instructed below

Refer directly to NCH ACU as instructed below – 0115 9934995


Uncomplicated STEMI Complicated STEMI accepted by NCH cardiology consultant

NCH ACU co-ordinator instigates PPCI protocol and checks NOTIS for recent blood results, clinic letters, previous PCI or CABG details

Ambulance crew takes patient to TCC ambulance entrance. Cardiac Nurse to meet ambulance crew at entrance to TCC

If expected transfer delay is over 60 minutes consider thrombolysis AFTER discussion with the NCH Cardiologist

KMH ED (or ward) staff to inform NCH ACU (0115 9934995) when the patient physically leaves KMH

Arrange transfer for PPCI

Telephone Nottingham City Hospital ACU (0115 9934995) with patient details and ETA.

Give Aspirin 300mgs orally and Prasugrel 60mg orally. OK to give if already on antiplatelets/anticoagulants (Heparin is not required at this point)

KMH ED (or ward) staff to activate EMAS – dial 999 and book as

Time critical transfer – escort if appropriate

Blue light transfer directly to Trent Cardiac Centre CSSU – ground floor

NCH ACU to liaise with NCH anaesthetists if patient intubated / ventilated (see p.8)

If patient stable and after cardiology consultant review at TCC, transfer for PPCI felt to be clearly inappropriate, then transfer back to KMH ED may be considered

Minimum transfer data required - Name - DOB - NHS number


Nottingham University Hospitals (Nottingham City campus) PPCI referral pathway for STEMI patients presenting via

EMAS

No Yes

Out of hospital VF/VT arrests who are successfully defibrillated / conscious / having a STEMI should be transferred to TCC NCH for PPCI.

Out of hospital cardiac arrests requiring intubation and ventilation should be transferred to the nearest ED. They will stabilise the patient and liaise with TCC NCH for transfer for PPCI if appropriate.

ONLY STEMI patients will be accepted directly to TCC NCH.

All other patients should be admitted to the nearest ED.

Keep all STEMI patients connected to the defibrillator until transfer onto the hospitals cardiac monitor

Give all EMAS times to receiving staff to enable completion of call to balloon and door to balloon times

1. Patient must be STEMI (in cases of doubt consider using FAST ECG APP)

Is there 2mm or more ST elevation in 2 or more consecutive chest leads? (not including V1)

OR

Is there 1mm or more ST elevation in 2 or more limb leads? OR

Posterior STEMI - Is there ST depression in 2 or more chest leads (V1-4) and 0.5mm or more ST elevation in 1 or more posterior leads (V7-9)?

OR

Is there left bundle branch block with compelling clinical features of MI? (ie chest pain, SOB, clammy, severely unwell etc)

2. Has the patient had cardiac sounding chest pain for <12 hours NB. Patients who present without chest pain may be considered for PPCI if they present with ST elevation (as above) with associated symptoms of

collapse with complete heart block or

acute SOB with associated symptoms ie pale, clammy

No

Advise patient of situation; and transport under emergency conditions to CSSU (ground

floor) NUH Trent Cardiac Centre (City Campus)

Yes

Transport to nearest Emergency Department

under emergency conditions – pre alert

Patient accepted

Phone NCH ACU co-ordinator 0115 9934995 (red phone)

Transport to nearest hospital –

pre-alert


Anaesthetic Support for Emergency Cardiology Cases Trent Cardiac Centre - Cardiac Catheter Laboratory

Adult ICU will usually provide bed, with CICU as alternative if required.

Emergency anaesthetic support Week Days 08:00 to 16:00 hours

Phone CICU (59856 or 53154) and ask for CICU anaesthetist.

CICU anaesthetist will arrange for an ODP to attend and will

contact City Critical Care Consultant to organise a bed

If cardiac theatres are unable to release staff bleep main theatre

coordinator on 284-2501 to book urgency 1 case

Emergency anaesthetic support Outside above hours or at weekend

Call switchboard (ext 56155) ask for CITY Critical Care

Consultant

Call 2nd on-call Anaesthetic Bleep Holder at City Hospital:

284 - 2117 / 2021 (this person attends the Cath Lab)

Bleep main theatre coordinator on 284-2501 to book urgency 1

case and main theatres ODP

Once contacted, organising a bed will be the responsibility of the

City Critical Care Consultant

If you need immediate help and CICU anaesthetist is not available - Dial 2222 and ask for the cardiac arrest team anaesthetist to attend.

Anaesthetic drug box kept in lab fridge. Ensure 2 bags N.saline also in fridge.

If anaesthetic machine in Lab 1 in use, a second machine is required - from CICU theatres or from Lab 4

During case ensure Adult Critical Care bed (or failing that CICU) is arranged


OPERATIONAL GUIDELINES

Primary percutaneous coronary intervention (PPCI)

Background According to the National Infarct Angioplasty Project 2008 ‘Primary angioplasty or primary percutaneous coronary intervention (PPCI), as it is known within the NHS, has been proven to lead to better longer-term outcomes for patients suffering a heart attack.’ PPCI is associated with fewer complications than with the usual treatment (thrombolysis), a lower recurrence of heart attack, low incidence of stroke and a lower mortality rate. It also provides patients with a higher level of satisfaction compared to conventional treatments It has been widely demonstrated that the shorter the treatment times for patients the better the outcome. The call to balloon time for PPCI should be no longer than 120 minutes with the door to balloon times set at 90 minutes or under Nottingham University Hospital City Campus (NUH) was given Heart Attack Treatment Centre status at the end of 2009. It is recognised that centres such as NUH doing high numbers of PPCI procedures have better patient outcomes. It is also recognised that, for PPCI to work well, there needs to be a highly experienced cardiac catheter lab multi-disciplinary team who show good quality team working across professional boundaries PPCI was commenced on a 09.00 to 1700 hours basis from March 2008, and was changed to a 24 hour service from October 2010 for Nottingham City patients. From March 2011 all patients were accepted from East Midlands Ambulance Service (EMAS) and outlying hospitals within a 60 minute radius of NUH Aims To ensure that the service provides a smooth and seamless patient pathway and to minimize delays in treatment, which may result in worse clinical outcomes for the patient. Government targets require a call to balloon time within 120 minutes and a door to balloon time within 90 minutes


Current Situation Establishment Consultant Cardiologist and cardiology registrars provide medical cover within the catheter lab. External interventional cardiologists can provide medical cover, dependent upon NUH approval The radiography department and the technical cardiology department will provide staff members to cover their roles within the catheter lab. CSSU/catheter lab staff provide nursing staff. Some nursing staff have received training to provide a radiography service when required A senior nurse from ACU will triage the referral call and activate the PPCI pathway. Staffing numbers It is agreed that a minimum of 7 persons be available to take part in each of the staff disciplines. All staff groups will be responsible for ensuring that the rotas are covered and that the rotas are done and uploaded to the shared drive area

Roles and responsibilities Prior to PPCI The night before all the labs should be fully stocked. Technicians to set up (or leave at the ready) a transducer, fluid and ECG stickers. Room to be set up as ready as possible to receive patient straight into Contacting the catheter lab team Mon – Fri 0800-1800 ACU staff will phone PPCI scheduler on 51854 and inform staff of the imminent arrival of a PPCI patient with an expected time of arrival. This message will be relayed to the Cardiac Catheter lab staff who will then decide which lab will become available first. This is always a joint decision between all staff groups within both cardiac catheter labs Out of hours (Mon – Fri 18.00-0800, Sat, Sun and bank holidays): The team of Consultant, Registrar, Cardiac Physiologist, Radiographer and Nurse are contacted via a bleep system as outlined in appendix 1. A list of the staff rotas can be found on the PPCI shared drive area (see below) and also in the PPCI guidelines folders which are in Cath labs 1 and 2, and on the Acute Cardiac Unit Monday to Thursday, at present, a nurse is resident on site from 19:00- 07:30hrs.


On the patients arrival to hospital Preparation of the Cardiac catheter lab The team will leave the labs set up as far as possible before leaving. The lab nurse will collect the relevant keys (either stored on CSSU Mon-Sat lunch or ACU weekends and bank holidays). They will get the required drugs and equipment out. The team will switch on the X-ray kit and hemodynamic kit. Where possible the patient’s demographics will be entered onto TOMCAT The team along with the ACU nurse will start the procedure when all team members have arrived Role of ACU/CSSU nurse The Senior nurse from ACU will triage the call, inform the catheter lab team of the imminent arrival of the PPCI patient, and meet the ambulance upon its arrival. They will then co-ordinate the preparation of the patient pre procedure. During the procedure they should assist the lab staff as much as possible and keep relatives informed of the patients’ progress Post procedure Most PPCI patients will be discharged after 48 hours post PPCI All PPCI patients should be referred to the cardiac rehabilitation team. If the patient is out of area the NUH cardiac rehabilitation team will refer to the relevant hospital cardiac rehabilitation team Follow up in out-patients will be either at the ACS clinic or at the interventional consultant’s out-patient clinic Bed availability ACU and the bed management team will ensure that beds are available for emergency admissions. Should there be no beds within cardiology the hospital bed management team should be informed. Should there be no help form the hospital bed management team then silver in command should be informed If non-cardiac patient All cardiology admissions should be taken into cardiology beds. If the patient is deemed to be not appropriate for cardiology by the registrar or consultant cardiologist they can be sent to the patients’ nearest ED unit and the ED staff informed of the admission as per NUH transfer (repatriation) of patients to the local hospital policy (2008)


Repatriation policy Any patients who will be staying longer than 3 days may be returned to their nearest hospital as per NUH transfer (repatriation) of patients to the local hospital policy (2008) Multiple patients If several patients arrive needing PPCI then the consultant will make the decision about order of cases and whether thrombolysis should be considered. This will be on an individual basis

Patient Pathways EMAS and patient pathway EMAS will phone directly through to Acute Coronary Unit (ACU) as per patient pathway above (page 7) Referral via other routes All PPCI patients should be phoned through to ACU from other referring centres as per patient pathways above (pages 3-6)

Anaesthetic support

Anaesthetics support is available for patients whose airway is compromised. Please see pathway above (page 8)

Audit

All primary angioplasty procedures will be audited to identify call to balloon and door to balloon times where data is readily available. All reasonable means will be used to establish missing data. This data will form the basis of the MINAP audit database. Monthly audit figures are produced for directorate and board level. PPCI data will be available for discussion at cardiology audit meetings

Avoidable delays to patient treatment will be investigated and acted upon by the cardiac outreach nurses in the first instance, and escalated to directorate lead if necessary


Miscellaneous

Staff sickness Please cover the shift yourself by contacting your colleagues one by one. Their phone numbers are available through switch board. If you are unable to cover please let your manager know Named consultant Patients are to be cared for under the consultant who performed the procedure in most cases unless the patient is already known to a different interventional cardiology consultant Radiology regulations All IRMER regulations and local radiation rules will be adhered to Intra-aortic balloon pumps Intra-Aortic Balloon Pump (IABP) – Patients requiring IABP insertion usually require the procedure urgently. All catheter lab nursing staff have had basic training in the IABP sensation equipment. This will enable them to set up the IABP usually without the assistance of the perfusion team. If the catheter lab team are not confident in setting up the IABP themselves, the perfusionist on call can be contacted via switch board

Confidentiality

All confidentiality of data will be adhered to as per trust protocol - All parties will endeavour to maintain appropriate confidentiality regarding information that is proprietary to each of the Partners within the context of shared working

Info on shared drive All pathways and rotas can be found on the shared drive area.This can be accessed via the Trent Cardiac Centre on the P: drive in cardiology folder Mobile Phone A mobile phone is available for use whilst waiting for the patient. It is kept on ACU. See NUH Issue, Use and Security Of Trust Mobile Phones Provided To Staff Procedure policy (2008)


PPCI Service (SOP) In hours Monday –Friday 9am-5pm

Subject Heart Services PPCI Service

Effective Date July 2019

Owners Paul Webb, Kathy Allsopp, Tim Graves, Liz Cope, Simon Brown

Version Draft 7

Instruction

Red phone rings on ACU nurses’ station

Answered by Senior Nurse on ACU who will take details, assess where patient needs to go and commences audit form

PPCI Nurse to activate primary team – Ring PPCI scheduler 51854 and inform staff of PPCI referral and expected time of arrival. CSSU inform Catheter Labs 1-2

Cath lab Nurse to access NOTIS for patients recent blood results and relevant medical history

Patient arrives at TCC – PPCI Nurse greets them in Ambulance and assesses and confirms STEMI (See PPCI guidelines p3-7)

Ensure Registrar/Consultant review in ambulance - if not STEMI, Registrar / Consultant to advise transport to appropriate department)

Cath lab Nurse escorts patient into Lab/recovery area

Cath lab Nurse ensures patient is prepared for procedure, cardiac monitored with defibrillator on at all times. Explain procedure, administer analgesia and anti-platelets, complete check list prior to entering lab

Cath lab Nurse administers medicines as required and ensures lab staff are aware of all medications given

Cath lab Nurse escorts patient into lab and stays within lab - Liaises with Ambulance crew, assists lab nurse with drug checking and administration, assist with cardiac arrest

Cath lab Nurse completes PPCI audit form, admit patient onto hospital system, commence nursing paperwork

Cath lab Nurse to liaise with relatives and keep them informed

Cath lab Nurse liaises with ACU co-ordinator to ensure bed available

Cath lab Nurse escorts patient to ACU post procedure and ensures complete handover to ACU staff

If a further PPCI call during current procedure, liaise with lab cardiologist regarding course of treatment

Special circumstances

Patient transfer from QMC, Kings Mill, Newark and Ilkeston hospitals please refer to PPCI guidelines p.3-6

Patient requiring ventilation: Consultant in lab is informed. See PPCI guidelines p.8


PPCI Service (SOP) Out of Hours Monday – Friday 5pm -9am and Saturday, Sunday & Bank

Holidays 24hours

Subject Heart Services PPCI Service

Effective Date July 2019

Owners Paul Webb, Kathy Allsopp, Tim Graves, Liz Cope, Simon Brown

Version Draft 7

Instruction

Red phone rings on ACU nurses’ station

Answered by Senior Nurse on ACU who will take details, assesses where patient needs to go and commences audit form

Senior ACU Nurse to activate primary team – The team of Consultant, Registrar, Cardiac Physiologist, Radiographer and Nurse are contacted via a bleep system. If no response from PPCI team within 10 minutes then ACU staff will call PPCI team member directly. Telephone numbers and rota available in PPCI folder on ACU

ACU Nurse takes on call takes nurse in charge phone from ACU for duration of procedure

ACU Nurse to access NOTIS for patients recent blood results and relevant medical history

CSSU open M-F. Saturday, Sunday and Bank Holidays ACU Nurse and HCA will have to open up CSSU. Out of hours, keys are kept on ACU

Patient arrives at TCC – ACU Nurse and HCA greets them in Ambulance and assesses and confirms STEMI (See PPCI guidelines p3-7)

Ensure Registrar/Consultant review in ambulance - if not STEMI patient, Registrar / Consultant to advise transfer to appropriate department

ACU Nurse and HCA escorts patient into Lab/recovery area

ACU Nurse ensures patient is prepared for procedure, cardiac monitored with defibrillator on at all times. Explain procedure, administer analgesia and anti-platelets, complete check list prior to entering lab

ACU Nurse administers medicines as required and ensures lab staff are aware of all medications given

ACU Nurse escorts patient into lab and stays within lab to assist with procedure- Liaises with Ambulance crew, assists lab nurse with drug checking and administration, assist with cardiac arrest

ACU Nurse completes PPCI audit form, admit patient onto hospital system, commence nursing paperwork

ACU Nurse to liaise with relatives and keep them informed

ACU Nurse liaises with ACU co-ordinator to ensure bed available

ACU Nurse escorts patient to ACU post procedure and ensures complete handover to ACU staff

If a further PPCI call during current procedure, liaise with on call cardiologist/lab cardiologist regarding course of treatment

Special circumstances

Patient transfer from QMC, Kings Mill, Newark and Ilkeston hospitals please refer to PPCI guidelines p.3-6

Patient requiring ventilation: Consultant informed. See PPCI guidelines p.8


Appendix 1

Trent Cardiac Centre on-call Pacing & PPCI Incident Management– Standard

Operating Procedure (SOP)

Procedure Trent Cardiac Centre on-call Pacing & PPCI Incident Management

Author/Reviewer Darren Dovey Effective Date 05/02/19

Approvals Trent Cardiac On-Call Teams Review Date 05/02/21

Owners Trent Cardiac On-Call Teams Version 0.1

Document Preparation

Date Version Contributor/Reviewer Role Comment

29/01/16 0.1 Darren Dovey Applications

Manager, ICT

Services

Initial document

1. Introduction

The following outlines the standard operating procedures for incident management for TCC On-Call Pacing and PPCI out of hours notifications activiated via the everbridge platform and is to be used in conjunction with any other clinical SOP in relation to PPCI and On-Call Pacing Trent Cardiac Centre processes.

2. Process of steps

The following guidance is designed to detail the process steps involved in this part of the process.

Launching & Logging into Everbridge Manager

Rasing Incidents

o PPCI

o On-call pacing

Viewing Incidents & Repsonses

Submit a follow up on a Incident


Closing a Incident

3. Launching & Logging into Everbridge Manager.

To launch an incident you need to log into the Everbridge Manager application manager.

Double click on the Everbridge Mananger Icon on your PC desktop or enter the following URL

into a web browser https://manager.everbridge.net/login.

* Please note Everbridge is an externally hosted application so can be accessed from a device external to NUH with internet access using the above URL

Enter your Everbridge Username casesensative in the Username field.

Enter your Everbridge Password in the Password field.

Click ‘Sign-in’

* Everbridge usernames and passwords are not managed by NUH, reminders resets can be requested via the Everbirdge platform providing you can recall the details entered, requests can be sent via email by system administrators but this service will only be offered in core ICT Hours.

4. Raising Incidents

Staff logging incidents will require to have the access role NUH NHS Trust (TCC Operator) if this is not your primary role you will need to switch to this role.

4.1. PPCI Incident

Click on Launch Incident

Expand ‘Trent Cardiac Centre’ if not already expanded and select ‘Trent Cardiac PPCI’

The PPCI form will launch

Patient details is already populated with PPCI, additional none patient identifiable information

can be added if required.

Click Next

Review information if required scroll to the bottom of the screen and click ‘Send’

By default the required contacts will be selected as defined

4.2. On-call pacing

Click on Launch Incident

Expand ‘Trent Cardiac Centre’ if not already expanded and select ‘Trent Cardiac On-call

Pacing’

The On-call Pacing form will launch

Patient details is already populated with On-call Pacing, additional none patient identifiable

information can be added if required.

Click Next

Review information if required scroll to the bottom of the screen and click ‘Send’

https://manager.everbridge.net/login


5. Viewing Incidents & Responses

Hover over the incidents option in the top toolbar and click on Open/History

Select the relevant incident to open it.

The incidents details screen will be displayed displaying the sent notifications

You can open additional detail relating to the sent notification by clicking on the notification

title, to see who as responded alternatively for a summary of response hover the mouse

pointer over the chart.

6. Submit a follow up on a Incident

In the Incidents details screen click the drop down arrow next to actions and Send Follow up

Select which responses you are following up

Click Next

Add additional none patient identifiable information if required to the template if required

Click Next

Click Send

7. Closing an Incident

All Incidents should be closed once the incident as ended.

From the incidents details screen for your department

Select the drop down arrouw next to the actions in the status column.

Select ‘Close – without notification’

You will be asked to comfirm that you want to close the incident select yes.

*Please note you must ONLY select close without incident to ensure additional notifications are not sent.

8. Supporting Information

Everbridge – Registering user account and raise incident guide (Click Here)

http://nuhnet/ict_services/customer_services/training/Everbridge%20guides/Forms/AllItems.aspx

Full Title of Guideline: PPCI STEMI Guidelines 2019

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Transcript of Full Title of Guideline: PPCI STEMI Guidelines 2019